Short term mortality after acute myocardial infarction with ST-segment elevation
| Abstract Title: | Short term mortality after acute myocardial infarction with ST-segment elevation: A ten years comparison of patients with and without diabetes mellitus admitted with ST-elevation myocardial infarction in a hospital without interventional reperfusion facilities |
| Authors: | Calin Pop¹’², Liana Mos¹, Lavinia Pop², Mihaela Roman², Daniela Dicu² |
| Affiliation: | ¹”Vasile Goldis” Western University Arad, Romania ²Emergency County Hospital Baia Mare, Romania |
| Abstract text: | Objectives: To compare short term mortality after a first acute myocardial infarction with ST-segment elevation (STEMI) in patients with and without diabetes mellitus and to point out the factors associated with a worse prognosis. Methods: Between 2000/01/01 and 2009/12/31 in the intensive coronary unit of Emergency County Hospital Baia Mare there were admitted 1335 consecutive STEMI patients. In this group 660 patients had no reperfusion treatment and between them 142 (21.51%) were diabetic, and 675 patients received thrombolytic therapy and between them 136 (22.14%) were diabetic. The efficacy of thrombolysis was assessed with two noninvasive reperfusion criteria: 1. Rapid cessation of the chest pain; 2. Decrease of the sum of the ST-segment elevations by more than 50% at 180 minutes after the start of thrombolysis. In the absence of contraindications, all patients received beta-blockers, angiotensin converting enzyme inhibitors, statins, and anticoagulants according to currents guidelines. Results: The 278 diabetic patients (20.82%) of this registry were older and more likely to be women and they had additional comorbidities and coronary risk factors. At 30 days, absolute mortality was 19.43% in diabetic patients and 14.39% in non-diabetic patients (p=0.002). A significant lower in hospital mortality -11.38% was seen in the 539 patients without diabetes who received thrombolysis compared with the one of 16.52 % seen in the 136 diabetic patients who received thrombolysis (p=0.01) and with the 21.49% mortality seen in 142 diabetic patients with no reperfusion therapy. |
| Keywords: | mortality, STEMI, diabetic patients, myocardial reperfusion |
| Presentation type: | Poster |
| Correspondence: | no. 5 Culturii St., Baia Mare, Romania |
| Email: | medicbm@yahoo.com |
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